Hypopigmented Reed nevus

Abstract

Reed nevus, also named pigmented spindle cell nevus, is a peculiar melanocytic nevus, now regarded as a variant of Spitz nevus by the majority of authors. It is characterized by spindle-shaped melanocytes disposed in nests located in epidermis and papillary dermis. It is usually heavily pigmented, and many melanophages may also be present. Hypopigmented Reed nevus shows all the typical features of conventional pigmented spindle cell nevus, but it does not contain abundant melanin. This variant of Reed nevus is poorly described in literature, so we report five cases of hypopigmented Reed nevus and discuss its clinical and histopathological features.

Spitz nevus and Reed nevus

“…However, there is still no consensus in the literature. 8 In 1975, Reed et al 7,[11][12][13][14][15] described a deeply pigmented melanocytic lesion, also benign, found especially in the lower extremities of young adults. Some authors consider it as a single nosological entity, but others refer to it as a pigmented variant of the classic Spitz nevus, with its own clinical and histological features.…”

“…Some authors consider it as a single nosological entity, but others refer to it as a pigmented variant of the classic Spitz nevus, with its own clinical and histological features. 6,7,11,12,13,14,16,17 Whether Spitz and Reed nevi are distinct lesions is still debatable. 6 For this reason, some authors try to differentiate them in histological types, but there are controversies, as the combination of their microscopic characteristics is very common.…”

“…Evolution time, from its onset until diagnosis, can vary from weeks to years, and the typical presentation in childhood is the development of a pink or reddish (due to lack of melanin) fast growing papule, located in the head or neck. 6,7,13 In adults, it usually presents as a brown or black papule or plaque located in the trunk or lower limb, being pigmented in 72% of the cases and infrequent in the palmoplantar region. 1,6,20 Hypopigmented lesions can be mistaken by amelanotic melanoma and its polypoid variant shows similarities with polypoid melanoma.…”

Calcinosis cutis metastásica: Calcifilaxis (arteriolopatía urémica calcificada). A propósito de un caso [Metastatic calcinosis cutis: calciphylaxis (calcified uremic arteriolopathy). A case report]

“…Afecta casi con exclusividad a pacientes con insuficiencia renal crónica terminal, que son sometidos a diálisis o han sido trasplantados [1]. Se caracteriza por la aparición y rápida progresión de necrosis isquémica y úlceras cutáneas causadas por la calcificación de la íntima de las arterias y las arteriolas de la dermis profunda y la grasa subcutánea.…”

“…La mayoría de los pacientes afectados tienen aumento de los niveles séricos de calcio y fosfato, además de niveles elevados de hormona paratiroidea. Sin embargo el metabolismo calcio-fósforo es normal en algunos pacientes con calcifilaxis, lo que avala la idea de que también participan otros factores en la patogenia [1,2]. La elevada morbi-mortalidad de este síndrome justifica un diagnóstico precoz y un tratamiento agresivo.…”